To summarize the first aid and nursing experience on early hepatic artery thrombosis of domino liver transplantation for a child with familial hypercholesterolemia. In order to solve the problems of atypical early clinical symptoms of hepatic artery thrombosis，easy occurrence of bleeding and infection during thrombolytic therapy，we adopted measures such as early identification of hepatic artery thrombosis，special management of catheter contact thrombolytic therapy，precise anticoagulation management，continuous low negative pressure abdominal irrigation，individualized nutrition management and skin management of xanthoma. After active treatment and meticulous care，the child was stable and discharged from the hospital and followed up for more than 4 months，with a good prognosis.